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14 Alternatives to Knee Replacement Surgery in 2021

Is joint pain, swelling, and stiffness limiting you from doing many day-to-day tasks? While your arthritis should not restrict you from living life fully, sadly, it does! On top of this, the thought of invasive surgery can be tormenting. In this case, new alternatives to knee replacement surgery can help you and your loved ones.

Treating Knee Pain with Replacement Surgery Alternatives

We explore fourteen different options for the better health of an arthritic patient. You’ll see a range from home remedies to conventional methods to new-age non-surgical solutions. From these, you can choose to put your faith in any that feels and fits the best.

Advanced Knee Replacement Alternatives

1. Gold Injections – We Bet You Didn’t Know About This!

This new gold microbeads injection is a drug-delivery system devised by US & Danish scientists. After many animal and human-based studies, it was launched in 2017. A pilot study also showcases the success of this therapy.

  • How does the new gold injection treat osteoarthritic pain?
How does the new gold injection treat osteoarthritic pain?

Gold injections interfere with the zinc-based pain pathways, which lead to reduced pain. Still, this injection does not just provide symptomatic relief! It actually works on the underlying condition causing pain.

Macrophages-Immune Response

Macrophages are white blood cells recruited by the body to eliminate foreign particles that cause infection. Research confirms this anti-infection mechanism of macrophages.[1]NCBI Targeting Macrophages as a Potential Therapeutic Intervention “The well-known bipolar model [4,5] distinguishes macrophages into two main different subsets: pro-inflammatory (M1, classically activated via interferon-γ) and anti-inflammatory.” View in Article

Gold Microbeads Cause Immune-response

The body recognizes gold beads as foreign bodies and recruits macrophages to eliminate them. In this process, the macrophages attack the gold microbeads, thereby releasing the gold ions.

Gold Ions Blocks Pain-Pathways

The Gold-ions block the zinc-oriented pain-pathways. Now, the brain stops receiving pain signals. As soon as the pain is stopped, the edema also subsides.

Gold Goes Back to Being Inert

Since macrophages are no longer active, the gold microbeads stop releasing gold ions and go back to the inert stage. Therefore, “You get what you need and that too in the right amount,” as Dr. Robert quotes.

The Procedure

You will receive an intra-articular (IA) injection of 20mg gold microbeads into the affected knee joint. Ideally, you will see pain reduction in a day or so. However, immediate improvement in your gait is visible within 1-2 hrs.

Hence, it’s an on-demand pain reliever. In case if there is no inflammation, these injected particles will remain inert.

Old Vs. New Gold Injections

Not to be confused with older DMARD gold injections for rheumatoid arthritis! They reduce the immune system’s response. Therefore, older gold injections cannot be a long-term treatment due to the increased risk of infection. Connect with our team to know more about new gold therapy.

New Gold-Injections for Osteoarthritis Summarised!

The new approach comes with a set of some advantages and disadvantages. Despite the drawbacks, you will find the results are quite reliable. Check out this list to know the benefits, risks, and expected results of the latest treatment option:


  • Non-invasive – No scarring, Less pain
  • No blood transfusion – Low infection risk
  • Non-immune-suppressing – No risk of infection
  • Pure gold – Non-toxic, unlike other gold injections
  • One sitting (under 30 min) – Time-saving
  • One-time – Saves on cost, time
  • Fast-acting – Quick recovery
  • Low cost – Save money


  • Not yet approved by FDA
  • Long term results not available
  • Long-distance travel to Mexico


  • Reduced friction between bones while moving
  • Alleviates knee pain
  • Reduce inflammation and swelling
  • Provide long-term relief
  • Improves joint mobility

Not sure if you want to go for it? Get your case medically reviewed by our team of doctors. Connect with us and avail your first virtual consultation with the doctor for free.

2. Stem Cell Therapy

Research shows that stem cell therapy improves cartilage quality. Moreover, it provides pain relief and a better quality of life.[2]NCBI Bone Marrow-Derived Stem Cells in Knee Osteoarthritis “resulted into pain relief, minimized donor-site morbidity, provided a better quality of life…” View in Article But this treatment is not yet part of standard medical practice. There is no standardization regarding the source and dose of stem cells.

Hence, researchers recommend an in-depth study to derive the optimal dose. They also recommend a standardization in methodology.[3]NCBI Stem Cell Treatment for Knee “Future research directions should include work on elucidating optimal cell concentration and dosing, as well as standardization in methodology.” View in Article

3. Platelet Rich Plasma (PRP) Therapy

Platelets are rich in growth factors, hence help to treat the knee. PRP therapy involves three steps:

Step 1: Draw blood from the patient

Step 2: Extract platelets from the whole blood

Step 3: Injecting these in the knee joint

Research recommends that PRP injections might improve knee pain and inflammation.[4]Journal of Orthopaedic Surgery and Research Platelet-rich plasma therapy in knee osteoarthritis “Pain symptoms and severity of clinical osteoarthritis symptoms decreased.” View in Article The existing National Institute for Health and Care Excellence (NICE) guidelines also report no major safety concerns.[5]NICE Interventional procedures guidance “Current evidence on platelet-rich plasma injections for knee osteoarthritis raises no major safety concerns.” View in Article

But evidence on its efficacy is insufficient and requires more research. There is also an absence of standardization in its preparation and administration.

4. Prolotherapy

In prolotherapy, the physician injects dextrose solution in the affected area. This solution stimulates the healing step by increasing the blood flow to that area.

Research shows that prolotherapy reduces pain and stiffness. Moreover, you may see a constant and significant improvement in joint function.[6]Jounal of Orthopaedic Surgery and Research Platelet-rich plasma therapy in knee osteoarthritis “WOMAC pain −5.41, 0.61, <0.001; WOMAC stiffness −1.76, 0.31, < 0.001” View in Article

While this procedure is safe, it requires more research. Hence, the 2019 Arthritis Foundation guidelines do not recommend its use.[7]Arthritis Foundation Prolotherapy for Osteoarthritis “I would not recommend prolotherapy because I believe the jury is still out on its efficacy,” says Julius Oni, MD, assistant professor of orthopedic surgery at Johns Hopkins University School of Medicine in Baltimore, Maryland. View in Article You should follow your doctor’s advice to see if this can help you.

5. Hyaluronic acid (HLA) Injections

HLA injections may help to do these:

  • Lubricate the knee joint
  • Improve shock absorption
  • Reduce pain
  • Enhance joint mobility

While results do look promising, they can still use more research. There is not enough proof about its effects. Thus, the Arthritis Foundation guidelines do not currently recommend their use.[8]Rheumatology Advisor 2019 ACR/Arthritis Foundation Guidelines “Intra-articular hyaluronic acid injections are strongly recommended against in patients with hip OA. Evidence about the lack of benefit of hyaluronic acid injections in hip OA is of higher quality.” View in Article

Hyaluronic acid (HLA) Vs. Gold Injection

The gold injections, compared to HLA, can be a better alternative for you. Doctors use HLA injections to provide symptomatic pain relief for osteoarthritic patients. On the other hand, gold injections focus on treating the underlying condition for OA.

Conventional Knee Replacement Alternatives

6. Medications

NSAIDs (nonsteroidal anti-inflammatory drugs) may reduce pain, inflammation, and swelling. But its prolonged consumption may cause stomach ulcers, kidney damage, and gastrointestinal bleeding.[9]NCBI Drugs in Osteoarthritis “All non-steroidal anti-inflammatory drugs (NSAIDs) have the potential to induce adverse events… including gastrointestinal ulcers and bleeding (COX-1), hypertension and kidney injury.” View in Article Another option can be over-the-counter (OTC) drugs.

7. Steroid Shots

Corticosteroid administration can reduce knee pain and inflammation. The pain relief lasts for several weeks. The 2019 Arthritis Foundation guidelines recommend their use.[10]Rheumatology Advisor 2019 ACR/Arthritis Foundation Guidelines “Topical NSAIDs are conditionally recommended for patients with hand OA.” View in Article

8. Therapeutic Option – Acupuncture

Acupuncture uses thin, sharp needles to alter the energy flow within the body. It brings relief from joint pain and has a low risk. But research suggests that the comfort will remain only for the short-term.

Furthermore, it can improve short-term and long-term physical function.[11]PubMed The Effects of Acupuncture on Chronic Knee Pain “The acupuncture groups showed superior pain improvement and physical function in the short term (up to 13 weeks). The acupuncture groups showed superior physical function but not superior pain improvement in the long term (up to 26 weeks).” View in Article Hence, the 2019 Arthritis Foundation guidelines support its use.[12]Rheumatology Advisor 2019 ACR/Arthritis Foundation Guidelines “Acupuncture is conditionally recommended for patients with knee, hip, and/or hand OA.” View in Article

9. Physical Therapy Yoga and other Exercises

Physical therapy aims to reduce pain and strengthen knee muscles. A physical therapist will guide you to make sure you are doing the exercises correctly.

The therapy approach may include

  • Ice and heat application
  • Neuromuscular training
  • Strengthening exercises
  • Stretching exercises

You should avoid twisting and running that can aggravate the knee injury. Reducing activities like climbing stairs or knee bending can also help. Check out this 15-min yoga routine for your knees. It avoids the struggle you may face while doing squats, lunges, & bends!

Knee Friendly Yoga by MSUNN Yoga & Wellness

10. Assisting Aids

Assisting aids include walking canes and braces. These devices perform the following functions:

  • Strengthen the knee muscles
  • Improve mobility
  • Better stability and support
  • Help prevent knee pain and inflammation from getting worse.

11. Ancient Medicine (Ayurveda)

Allopathy can have side effects, but Ayurveda does not. Ayurveda starts to reduce arthritic symptoms after three months. Moreover, it can help in preventing disease progression naturally. Thus, it is a slow yet safe treatment option that may work for you.

Ayurveda treatment involves the combination of massage, meditation, exercise, and a nutritional diet. However, it is an individualized treatment according to the patient’s condition.

Ayurveda naturally revives damaged cartilages and prevents further deterioration in the knee joint. A PubMed research article shows that Ayurveda significantly reduced knee pain and improved knee function.[13]PubMed Ayurvedic medicine…knee osteoarthritis “Ayurvedic formulations (especially SGCG) significantly reduced knee pain and improved knee function.” View in Article

12. Surgical Alternative: Osteotomy

Osteotomy involves removing weight from the affected part of the knee. Hence, this weight shift helps in relieving symptoms. This procedure helps if there is less damage on only one side of the knee. However, it works more on younger people.

13. Surgical Alternative: Arthroscopy

Arthroscopy can repair a meniscus tear, ligament, bone, or cartilage inside the knee. It involves the use of a camera inserted through small incisions. Still, this technique may not help for all types of knee problems. It’s possible to go home a few hours after the procedure.

Recovery is comparatively quicker. Both these procedures can delay or end the need for knee replacement surgery.

14. Weight-Loss Strategy

Obesity can put excess stress on the knee joint. Studies show that a rise in every extra 10 pounds increases the risk of developing knee osteoarthritis by 36%.[14]NCBI High Weight Loss In Older Adults With Knee Osteoarthritis “These results suggest that a 10% weight loss in an overweight and obese osteoarthritic population elicits positive changes in the mechanical pathway to knee osteoarthritis…” View in Article So, losing 10 pounds may mean you have four times less force pressing on your knees.

Bariatric surgery can also reduce the excessive load from the weight-bearing joints, which may reduce osteoarthritic symptoms like trouble-walking and joint pain.

Alternatives to Knee Replacement Surgery Compared

Cost Recovery Inpatient Anesthesia
Gold Injection
First Knee: $10,000; Subsequent: $5,000 per joint 2-3 weeks No No
Stem Cell Therapy
$4,600 – $6,200

4-6 weeks

No Yes (G)
Platelet Rich Plasma (PRP) Therapy
$350 per session 4-6 weeks No Yes (L)
$100 – $200 per session Immediate No Yes (L)
HLA Injections
$310 per session Immediate No Yes (L)
>$15 Immediate No No
$98 – $110 per session 1-6 weeks No Yes (L)
$75 – $100 per session 1-4 weeks No Yes (L)
Physical Therapy
$97 – $129 per session Min. 6 weeks No No
Assisting Aids
$40 (Walking Cane) – $1,700 (Braces) N/A N/A N/A
$60 – $100 per session Min. 12 weeks No No
<$4,125 12-24 weeks Yes Yes (G)
$3,700 – $6,000 6-8 weeks Yes Yes (G)
Knee Replacement Surgery
≥$20,000 6-12 weeks Yes Yes (G)
*G: General Anesthesia; L: Local Anesthesia

In the comparison, you can see multiple methods share similar recovery times. However, the time for which the result lasts may differ. For example, long-lasting results are expected from gold injections. The HLA injections, though, last only for 3-5 weeks.

Options That Don’t Work

The 2019 Arthritis Foundation guidelines[15]Rheumatology Advisor 2019 ACR/Arthritis Foundation Guidelines “Thermal interventions (locally applied heat or cold) are conditionally recommended for patients with knee, hip, and/or hand OA. Paraffin, an additional method of heat therapy for the hands, is conditionally recommended.” View in Article recommend people not to use:

  • Modified shoes and insoles
  • Paraffin
  • Biologics
  • Iontophoresis
  • Kinesiotaping
  • Bisphosphonates
  • Chondroitin sulfate and Glucosamine supplements

  • Colchicine
  • Methotrexate
  • Hydroxychloroquine
  • Radiofrequency ablation
  • Pulsed vibration therapy
  • Tramadol opioids
  • TENS (Transcutaneous Electrical Nerve Stimulation)

  • What is the Right Time for Knee Replacement Surgery?
What is the Right Time for Knee Replacement Surgery?

Already tried most of these? Do you find a significant improvement in your symptoms? If not, you may likely consider knee replacement surgery.

Your doctor could advise a Total Knee Replacement Surgery (TKR), or a Partial Knee Replacement Surgery (PKR). It varies with the case. You can connect with us to find a licensed and celebrated surgeon overseas for free.

The Upshot

As you can see, these alternatives are not only cost-effective but also provide relief from symptoms. Moreover, a lot of major risks are involved in knee replacement surgery. In that case, why not give them a try?

Ultimately, it’s you and your physician who should determine the best possible option. But, remember there is a great chance to get back to your pain-free mobile life without knee replacement.